Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis from ovarian cancer

Piso Pompiliu, Dahlke Marc-Hendrik, Loss Martin, Schlitt, Schlitt Hans

Description

In selected patients with peritoneal carcinomatosis from ovarian cancer prognosis can be improved by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Methods Between September 1995 and February 1999, 19 patients (mean age 52 years, range 30–72 years) with peritoneal carcinomatosis from primary or recurrent epithelial ovarian carcinoma were operated with the aim of complete macroscopical cytoreduction. Surgery was followed by intraoperative HIPEC. The data was analyzed retrospectively. Results Eleven patients had recurrent and 8 primary ovarian cancer. The median progression free interval was 18 months (range 6–36 months). Macroscopically complete cytoreduction was achieved in 9 patients. Cisplatin (n = 16) or mitoxantrone (n = 3) were used for the intraoperative chemotherapy. The median intraabdominal inflow temperature was 41.5°C. Complications occurred in seven patients. Most frequent complications were anastomotic leakage (2/19) and intraabdominal abscess formation (2/19). One patient died postoperatively. The mean (± SD) overall survival time was 33(± 6) months with a 5-year survival rate of 15%. The survival was found to be influenced by the completeness of cytoreduction (44 ± 11 vs. 25 ± 6 months, p = 0.40), tumor volume (54 ± 10 versus 16 ± 4, p = 0.002) and presence of lymph node (38 ± 8 vs. 20 ± 8 months, p= 0.2) or liver metastases (51 ± 9 vs. 21 ± 6 months, p = 0.06). Conclusions Cytoreductive surgery combined with HIPEC is feasible and is associated with a reasonable morbidity and mortality. Complete cytoreduction may improve survival in select group of patients with low tumor volume and no organ metastases.

Sujets

• Ovarian cancer

Informations

• Publié par: biomed
• Publié le: 01 janvier 2004
• Nombre de lectures: 11
• Langue: English

Extrait

World Journal of Surgical Oncology

BioMedCentral

Open Access Research Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in peritoneal carcinomatosis from ovarian cancer 1 2 2 Pompiliu Piso* , MarcHendrik Dahlke , Martin Loss and 2 Hans Juergen Schlitt

1 2 Address: Department for Visceral and Transplant Surgery, Medical School of Hannover, 30623 Hannover, Germany and Department for Surgery, University of Regensburg, 93053 Regensburg, Germany Email: Pompiliu Piso*  piso.pompiliu@mhhannover.de; MarcHendrik Dahlke  [e-mail]; Martin Loss  [e-mail]; Hans Juergen Schlitt  [e-mail]regensburg.de * Corresponding author

Published: 28 June 2004 Received: 24 April 2004 Accepted: 28 June 2004 World Journal of Surgical Oncology2004,2:21 doi:10.1186/1477-7819-2-21 This article is available from: http://www.wjso.com/content/2/1/21 © 2004 Piso et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

peritoneal carcinomatosisovarian cancercytoreductive surgeryintraperitoneal chemotherapy

Abstract Background:In selected patients with peritoneal carcinomatosis from ovarian cancer prognosis can be improved by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).

Methods:Between September 1995 and February 1999, 19 patients (mean age 52 years, range 30– 72 years) with peritoneal carcinomatosis from primary or recurrent epithelial ovarian carcinoma were operated with the aim of complete macroscopical cytoreduction. Surgery was followed by intraoperative HIPEC. The data was analyzed retrospectively.

Results:Eleven patients had recurrent and 8 primary ovarian cancer. The median progression free interval was 18 months (range 6–36 months). Macroscopically complete cytoreduction was achieved in 9 patients. Cisplatin (n = 16) or mitoxantrone (n = 3) were used for the intraoperative chemotherapy. The median intraabdominal inflow temperature was 41.5°C. Complications occurred in seven patients. Most frequent complications were anastomotic leakage (2/19) and intraabdominal abscess formation (2/19). One patient died postoperatively. The mean (± SD) overall survival time was 33(± 6) months with a 5-year survival rate of 15%. The survival was found to be influenced by the completeness of cytoreduction (44 ± 11 vs. 25 ± 6 months, p = 0.40), tumor volume (54 ± 10 versus 16 ± 4, p = 0.002) and presence of lymph node (38 ± 8 vs. 20 ± 8 months, p= 0.2) or liver metastases (51 ± 9 vs. 21 ± 6 months, p = 0.06).

Conclusions:Cytoreductive surgery combined with HIPEC is feasible and is associated with a reasonable morbidity and mortality. Complete cytoreduction may improve survival in select group of patients with low tumor volume and no organ metastases.

Background Among gynecological

malignancies epithelial ovarian

cancer is the most common cause of death in the Western world and the majority of patients have an advanced

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